Investigation into the meaning of comfort, the components of comfort, and the process of comforting in Phase I of the project (1989-1992) revealed that comfort is a complex and context dependent construct. Clinical data shows that the process of providing comfort includes many concepts that constitute the theoretical foundations of nursing, and the strategies for providing comfort are central to nursing practice. The Aims for this five-year continuation grant are to continue this research identifying the construct of comfort and to continue developing a clinical nursing model of providing comfort. This will be achieved using three research approaches. The first study, planned to meet Specific Aim 1, is to continue the analysis of the process of providing comfort for the patient throughout various phases of the hospitalization, using grounded theory methods. Construction of this model commenced with exploration of patient experiences in the trauma room (Phase I) and will continue in Phase II with an exploration of the process that results in the patients relinquishing for care. Relinquishment of control and vigilance has been identified as an essential component of feeling safe, and consequently, of comfort. To make this model comprehensive, the work will continue with an explorations of the process of relinquishment for patients in the trauma room and in other care areas. The second study, planned to address Specific Aim II is to conduct an ethological (microanalysis) of comforting behaviors nurses provide for the trauma patient. This study will include microanalysis of videotapes of the comforting behaviors used with 50 trauma patients, and these results will later be compared with the comforting behaviors of nurses providing care to oncology patients with chronic pain. The third project, outlined as Specific Aim III is to continue the analysis of concepts embedded in the process of "making the patient comfortable." Investigation will continue with the examination of the concept of relinquishment, by comparing the fit of clinical data obtained from the grounded theory portion of the project with descriptions of relinquishment and related concepts in the literature. Thus the theoretical base of the model will be modified, developed, or verified as the project proceeds. These studies form an integral foundation for the identification of comforting interventions. Long-term objectives for this research program will be to develop nursing strategies for providing comfort and to test these interventions in the clinical setting.